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Starting Monday, every adult in India can get a free dose of the COVID-19 vaccine purchased by the federal government.
The policy reversal announced by Prime Minister Narendra Modi last week put an end to a complex vaccine purchase system that has exacerbated inequality in injections.
India is a major global supplier of vaccines, and its mistakes have left millions of people unprotected. Less than 5% of Indians are fully vaccinated.
Although policy changes may solve the problem of inequality, the problem of vaccine distribution still exists. In addition, poor planning means that vaccine shortages may continue.
The following are the changes in India’s vaccine policy and their implications:
Previous policy
The massive virus surge in March pushed India’s health system to a tipping point. Hundreds of thousands of people are newly infected every day, the hospital is full of panting patients, and the night sky glows from the busy crematorium burning corpses in the open.
At the time, India was vaccinating the most vulnerable people for free, but the states indicated a shortage of vaccines.
In May of this year, all adults can be vaccinated, but the Modi government has moved from taking the lead in vaccine supply to trying to distribute the vaccine to where it is most needed.
Instead, the federal government will purchase half of all vaccines and will continue to provide free injections to 300 million health care and frontline workers, as well as people over 45.
The state government and private hospitals will share the remaining vaccines to vaccinate more than 600 million adults under the age of 45.
However, experts warn that vaccine manufacturers may prioritize sales to the private sector for more profit.
A state health minister said that the Serum Institute of India will not respond to the state’s inquiries, and that the institute is producing AstraZeneca vaccines, which are mainly used in India.
Why it doesn’t work
India has one of the largest immunization programs in the world, vaccinating babies and mothers 300 million times a year.
But the states have never purchased a vaccine before. Health policy expert Dr. Chandrakant Lahariya (Chandrakant Lahariya) said that limited supply means that states are competing with each other, and the price paid is also higher than the price that the federal government can negotiate.
“This basically makes it inefficient,” he said.
When India started vaccination, it was designed to give priority to health workers, essential workers and the elderly. But the expansion of standards in the context of shortages has created inequality.
Since May, more people under 45 years of age have received the first dose of vaccine than people over 60 years of age. More than 74 million people over 60 years of age are still not vaccinated.
Modi said these decisions were made to suit the states, but Dr. Vineeta Bal, who studies the immune system at the Indian Institute of Science Education and Research in Pune, the western city of Pune, said the fractured response could lead to loss of life.
What has changed?
The federal government said it will buy 75% of all vaccines produced by Indian vaccine manufacturers and may renegotiate prices. These lenses will now be available to states for free distribution.
Private hospitals can purchase the remaining 25% at the capped price.
The states will vaccinate according to their population, disease burden and number of people vaccinated, and the wasted dose will be penalized.
But the biggest challenge will be to ensure continuous supply. Delhi Chief Minister Arvind Kejriwal said: “Where the vaccine comes from is a big question.”
India has ordered 300 million vaccine candidates Biological E for US$20562 million in its first agreement to obtain a vaccine in advance. But it is still being tested and has not yet been approved, so it may not have an impact on supply until later this year.
So far, there has been only one such deal, and experts believe that India’s dependence on existing, over-stressed suppliers (such as the Serum Institute) will not end soon.
At the same time, private hospitals do not know how they will purchase vaccines under the new policy. Some people say that because the price has been restricted, they are unlikely to continue to organize community vaccine activities.
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